アンドロゲン拮抗薬、アンドロゲン遮断薬

関: antiandrogen

WordNet

a drug that neutralizes or counteracts the effects of another drug
a muscle that relaxes while another contracts; "when bending the elbow the triceps are the antagonist"
male sex hormone that is produced in the testes and responsible for typical male sexual characteristics (同)androgenic_hormone

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対立する人,敵対者,競争相手(opponent)
アンドロゲン(男性ホルモン)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/14 10:06:42」(JST)

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Antiandrogens, or androgen antagonists, first discovered in the 1960s, prevent androgens from expressing their biological effects on responsive tissues.^[1] Antiandrogens alter the androgen pathway by blocking the appropriate receptors, competing for binding sites on the cell's surface, or affecting androgen production.^[2] Antiandrogens can be prescribed to treat an array of diseases and disorders. In men, antiandrogens are most frequently used to treat prostate cancer.^[3] In women, antiandrogens are used to decrease levels of male hormones causing symptoms of hyperandrogenism.^[4] Antiandrogens present in the environment have become a topic of concern. Many industrial chemicals, including phthalates and pesticides exhibit antiandrogenic effects.^[5]^[6] Certain plant species have also been found to produce antiandrogens. Environmental antiandrogens can harm reproductive organ development in fetuses exposed in utero as well as their offspring.^[5]

Medical uses

Antiandrogenic pharmaceuticals are used to treat an array of medical conditions that are dependent on the androgen pathway. Antiandrogens are often prescribed for men with prostate cancer, benign prostatic hyperplasia, hypersexuality, and male contraception. For women, antiandrogens are often prescribed for severe cases of acne, amenorrhea, seborrhea, hirsutism, androgenic alopecia, hidradenitis suppurativa, and hyperandrogenism, and for those that are undergoing gender reassignment.

Men

Antiandrogens in males can result in hyposexuality (diminished sexual desire or libido), reduced activity or function of the accessory male sex organs, and slowed or halted development or reversal of male secondary sex characteristics.^[7]

Antiandrogenic drugs are often indicated to treat severe male sexual disorders, such as hypersexuality (excessive sexual desire) and sexual deviation such as paraphilia (a disorder involving intense recurrent sexual urges), since lowering male hormone levels decreases libido.^[8] As a part of a program for registered sex offenders recently released from prisons, the offender is sometimes administered antiandrogen drugs to reduce the likelihood of repeat offenses by reducing sexual drive.^[8] On occasion, antiandrogens are used as a male contraceptive agent.

Prostate cancer

Decreasing the body’s response to androgen can have beneficial effects in treating prostate cancer. Prostate cancer is the most commonly diagnosed form of cancer found in men.^[3] Some prostate cancer cells require androgens for growth. To counteract cancer cell proliferation, antiandrogenic drugs are used for hormone therapy called androgen deprivation therapy. Some antiandrogenic drugs suppress androgen production while others inhibit androgens from binding to the cancer cells’ androgen receptors. These two classes of drugs can be prescribed separately or can be used together for a complete/combined androgen blockade. When the body is deprived of androgens, the therapy is termed castration-based therapy as the lack of androgens mimics castration. By competing with circulating androgens for binding sites on prostate cell receptors, antiandrogens promote apoptosis and inhibit prostate cancer growth.^[3] Hormone therapy antiandrogen drugs can be prescribed as monotherapy or in addition to radical radiotherapy or prostatectomy.^[3] Antiandrogen monotherapy generally causes fewer side effects in males, although it may block androgen less effectively than combined therapies. Monotherapy is often preferred by men as it is less likely than combined therapies to diminish libido or cause tenderness of the breasts, diarrhea, and nausea.^[9]

Androgen-deprivation therapy has been shown to cause initial reduction of prostate tumors.^[10] However, antiandrogenic drugs can cause prostate cancer tumors to become androgen independent. Androgen independence occurs when cells that are not reliant on androgen proliferate and spread, while cells that require androgen for survival undergo apoptosis. The cells that do not require androgen become the basis of the tumors, and cause recurring tumors a few years after the initial disappearance of the prostate cancer. Once prostate cancer becomes androgen independent, hormone therapy will most likely no longer benefit the individual and a new treatment approach will be needed.^[10]

In one study, the efficacy of reducing prostate cancer cells by castration was compared to combined androgen blockade in which castration is combined with an antiandrogenic drug. Flutamide, nilutamide and bicalutamide are nonsteroidal, "pure" antiandrogens. Flutamide has several side effects that the newer bicalutamide does not. Used in combination with castration, nilutamide and flutamide were found to have minimal effect on prolonging survival while bicalutamide significantly prolonged life in prostate cancer patients.^[11] As a result, since 2007 combined androgen blockade with bicalutamide has been used as an effective, safe, and cost-efficient treatment of prostate cancer.^[11]

5-alpha-reductase inhibitors such as finasteride, dutasteride, bexlosteride, izonsteride, turosteride, and epristeride are antiandrogenic as they prevent the conversion of testosterone to dihydrotestosterone (DHT).^[12] DHT is 3-5 times more potent than testosterone or other androgens (except in skeletal muscle tissue, where testosterone is the main androgen). They are unique because they do not counteract the effects or production of other androgens other than DHT. Dihydrotestosterone is necessary for development of both external male sex organs and the prostate. 5α-reductase inhibitors are most often used to treat benign prostatic hyperplasia since the resulting decrease in dihydrotestosterone inhibits proliferation of prostate cells.^[12]

Women

Hyperandrogenism is a condition found in women where ovaries overproduce androgens, which are typically considered male hormones as they are important for the development of male reproductive organs and secondary male characteristics.^[4] Antiandrogenic drugs can help to counteract male hormones that cause skin and hair problems in women. Gonadotropin, a pituitary hormone, is involved in ovarial androgen production and its suppression can result in reduced testosterone production. Antiandrogens can inhibit the release of the gonadotropic hormone, luteinizing hormone (LH), suppressing testosterone synthesis in the ovaries.^[13] Androgenic alopecia, a type of hair loss and pattern baldness, acne vulgaris, seborrhea, amenorrhea the absence of menstrual periods, hirsutism excessive facial and bodily hair in women, and hidradenitis suppurativa can be caused by an excess of male hormones.^[14]^{[date missing]}

Hormonal antiandrogen treatment is given to female patients that suffer from multiple symptoms of hyperandrogenism.^[15] Acne is the most common of skin disorders that result from male hormone overproduction. Fewer androgens present in a female’s tissues result in a reduction of oil (sebum) production and bumps (comedone).^[14] Antiandrogenic drugs are usually combined with topical and oral pharmaceuticals to treat severe acne. In women that suffer from hirsutism due to high testosterone levels, antiandrogenic drugs are used to slow hair growth, lighten hair color, and thin the hair. For females with male pattern hair loss, the androgenic alopecia, antiandrogens can assist in reducing hair shedding and thinning.^[14]

The most common antiandrogenic drugs used to treat women with hyperandrogenism are spironolactone and cyproterone acetate. Spironolactone, a synthetic 17-spirolactone corticosteroid is used primarily to treat low-renin hypertension, hypokalemia, and Conn's syndrome. Cyproterone acetate is a synthetic steroid, a potent antiandrogen that also possesses progestational properties. Oral contraceptives that mediate progesterone have no effect on androgens, but may be combined with spironolactone and cyproterone acetate for the purpose of correcting menstrual irregularities.^[14]

Antiandrogenic drugs are also used to purposefully prevent or counteract masculinisation in transgender women undergoing sex reassignment therapy, and to prevent symptoms associated with reduced testosterone, such as hot flashes, following castration.^[7]

Mechanism of action

Antiandrogens are classified as steroidal or nonsteroidal. Steroidal antiandrogens counteract androgens and thus also affect secondary sex characteristics. Steroidal antiandrogens directly affect gene expression due to their fat-soluble nature that allows them to diffuse through the plasma membrane’s phospholipid bilayer and prevent the binding of testosterone and dihydrotestosterone (DHT) to the androgen receptor.^[16]^{[date missing]}^{[publisher missing]}

Non-steroidal antiandrogens, or "pure" antiandrogens, such as nilutamide and flutamide, counter androgens and have no steroidal effects. Antiandrogens inhibit circulating androgens by blocking androgen receptors, suppressing androgen synthesis, or acting in both those ways.^[15] The most common antiandrogens are androgen receptor (AR) antagonists which act on the target cell level and competitively bind to androgen receptors.^[2]

Inhibition of androgen production occurs through a unique mechanism for each antiandrogen. For example, ketoconazole not only competes with androgens such as testosterone and DHT for androgen receptor binding, but also suppresses androgen synthesis by inhibiting cytochrome P450 and 17,20-lyase, which partake in synthesizing and degrading steroids, including the precursors of testosterone. The result is a decrease in the overall testosterone production of the adrenal cortex.^[17] Gonadotrophins, which are pituitary hormones capable of altering androgen synthesis, are also affected by antiandrogens. Antiandrogens can suppress gonadotropin secretion by down-regulating gonadotropin-releasing hormone receptors (GnRHR) in the pituitary gland. A decreased amount of GnRHRs results in gonadotropin-releasing hormone (GnRH) not being able to bind sufficiently. GnRH is responsible for the release of the gonadotropins luteinizing hormone (LH) and follicle-stimulating hormone (FSH). LH stimulates the Leydig cells of the testes and the theca cells of the ovaries to produce testosterone and indirectly estradiol. Therefore, if GnRH cannot bind, testosterone synthesis is not induced in testes or ovaries.^[13]^{[date missing]}^{[publisher missing]}

Environmental exposure

Exposure to antiandrogens can occur unintentionally due to natural or anthropogenic compounds in the environment. Environmental compounds affecting the endocrine system, termed endocrine disruptors, that antagonistically affect androgen receptors and androgen production can negatively affect individuals that come in contact with the compounds as well as their future generations.^[5] Certain pesticides and insecticides as well as in industrial chemicals contain antiandrogenic chemicals. Some species of plants produce phytochemicals with antiandrogenic effects. Exposure to these environmental antiandrogens has resulted in adverse effects on animals that allude to human health risks.

Pesticides and insecticides

Exposure to pesticides with antiandrogenic properties has been found to negatively affect humans and laboratory animals. Androgens are important in fetal development as well as in pubertal development. Exposure during critical periods of development can cause reproductive malformations in males while exposure after birth and before puberty can delay puberty.^[5]

Animal studies with vinclozolin, procymidone, linuron, and the DDT metabolite dichlorodiphenyldichloroethylene (p.p’-DDE) have shown irregular reproductive development due to their function as androgen receptor antagonists that inhibit androgen-activated gene expression.^[5]^[18] Even with low doses of antiandrogenic pesticides, developmental effects such as reduced anogenital distance and induction of areolas were seen in male rats.^[5]

Animal studies show that deformities result in offspring exposed to antiandrogens.^[5] Male mice can display malformations that resemble the reproductive organs of females as in the case of exposure to vinclozolin or proymidone. Exposure to vinclozolin or procymidone in utero feminized male offspring, as seen in abnormalities of anogenital distance, small or absent sex accessory glands, hypospadias, undescended testes, retained nipples, cleft phallus, and presence of a vaginal pouch. Male mice exposed before puberty to vinclozolin experienced delayed pubertal development visualized by delayed onset of androgen-dependent preputial separation.^[5]

Ketoconazole's imidazole derivative is used as a broad-spectrum antifungal agent effective against a variety of fungal infections. Although ketoconazole is a relatively weak antiandrogen, side-effects seen as a result of exposure include serious liver damage and reduced levels of androgens from both the testicles and adrenal glands.^[5]

Organophostphate insecticides such as fenitrothion can also behave as androgen receptor antagonists. Fenitrothion was found to completely inhibit dihydrotestosterone-dependent human androgen receptor activation, resulting in reduced weights of seminal vesicles and the ventral prostate. Structural similarity of fenitrothion with linuron further supports the findings of antiandrogenic activity.^[18]

Industrial chemicals

Industrial chemicals with antiandrogenic effects are ubiquitous in the environment. Consumer products such as toys and cosmetics may contain phthalates or parabens, which disrupt androgen synthesis.^[5]^[6]

Phthalates are mainly found as softeners in plastics, but also perfumes, nail varnish and other cosmetics. Fetuses that are exposed to a mixture of pthalates in utero may show signs of disrupted reproductive development.^[6]^[19] When Di-n-butyl phthalate (DBP), diisobutyl phthalate (DiBP), benzyl butyl phthalate (BBP), Bis(2-ethylhexyl) phthalate (DEHP) and di-n-pentyl phthalate (DPP) were combined, reductions in both testosterone synthesis and gene expression of steroidogenic pathway proteins were seen. The results in male rats were undescended testes and abnormal development of reproductive tissues.^[6]

Parabens are used as preservatives and/or antimicrobial agents and commonly found in food, soap, detergent, toothpaste, disinfectant, cosmetic and pharmaceutical products. Paraben esters, such as butylparaben, have been found to mimic androgen antagonist activity. Antiandrogenic endocrine disruption has been shown in aquatic species, but the mechanism is unknown. Researchers believe parabens have the ability to bind to human androgen receptors but it still remains unclear.^[19]

Phytochemicals

Antiandrogenic chemicals can also occur naturally in plants.

The best known plant-derived anti-androgen is 3,3'-Diindolylmethane^[20]^[21] found in cruciferous vegetables, which are members of the cabbage family.

Spearmint tea has proven antiandrogenic properties in females with hirsutism per a 2007 randomized clinical trial.^[22]^[23]

Scutellaria baicalensis, a blue flowering plant grown in Russia over Mongolia to China and Korea, may also have antiandrogenic properties.^[24]

The compound N-butylbenzene-sulfonamide (NBBS) isolated from the bark of Prunus africana, the Subsaharan red stinkwood tree, is a specific androgen antagonist and has been used as alternative medicine in benign prostatic hyperplasia.^[25]^[26] It also contains the antiandrogenic compound atraric acid.^[27]

Licorice, or Glycyrrhiza glabra native to southern Europe, India, and parts of Asia has shown antiandrogenic activity in male rats.^[28]

A herbal formula termed ka-mi-kae-kyuk-tang or short KMKKT containing Korean Angelica gigas Nakai (Korean Angelica) root and nine other oriental herbs was shown in 2006 to have in vitro anti-androgen activity. This was traced to decursin contained in Korean Angelica.^[29]

Duke's database (enter 'antiandrogenic' in search field) lists several more herbs that have antiandrogenic properties.

Future research

Currently, further research is being conducted on the effects of antiandrogens. In the pharmaceutical industry, researchers continue to experiment with antiandrogenic drugs and other treatments in the hope of finding cures to diseases such as prostate cancer. Greater insight into the mechanisms and pathways of antiandrogens would provide more effective treatment that might decrease the likelihood of recurrent prostatic tumors.

The future of antiandrogenic drugs is believed to be peptide antagonists. Current androgen receptor antagonist drugs bind to the ligand binding domain on the receptors and inhibit receptor function. Androgen receptor peptide antagonists act in an alternative manner. A peptide antagonist interrupts androgen receptor protein interactions from the surface of the receptor.^[30] This approach is "mechanism-based" and has greater potential for blocking receptor activity than the traditional ligand-receptor binding approach. Researchers are trying to target the ligand-binding domain and N-terminal domain of androgen receptors.^[30]

Discovery and development

References

^ "Medical Dictionary: Anti-androgen".
^ ^a ^b Mowszowicz I (1989). "Antiandrogens. Mechanisms and paradoxical effects". Ann Endocrinol (Paris) 50 (3): 50(3):189–99. PMID 2530930.
^ ^a ^b ^c ^d Gillatt D (2006). "Antiandrogen treatments in locally advanced prostate cancer: are they all the same?". J Cancer Res Clin Oncol 1: S17–26. doi:10.1007/s00432-006-0133-5. PMID 16845534.
^ ^a ^b "Medical Dictionary: Hyperandrogenism".
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j Gray LE, Ostby J, Furr J, Wolf CJ, Lambright C, Parks L, Veeramachaneni DN, Wilson V, Price M, Hotchkiss A, Orlando E, Guillette L (2001). "Effects of environmental antiandrogens on reproductive development in experimental animals". Human Reproduction Update 2 (3): 248–64. doi:10.1093/humupd/7.3.248. PMID 11392371.
^ ^a ^b ^c ^d Rider CV, Furr JR, Wilson VS, Gray LE Jr (Apr 2010). "Cumulative effects of in utero administration of mixtures of reproductive toxicants that disrupt common target tissues via diverse mechanisms of toxicity". International Journal of Andrology 33 (2): 443–62. doi:10.1111/j.1365-2605.2009.01049.x. PMC 2874988. PMID 20487044.
^ ^a ^b "Antiandrogen Drugs".
^ ^a ^b "Anti-androgens for sex offenders". Canadian Medical Association Journal 109 (4): 257. 1973. PMC 1946843. PMID 20312137.
^ Kolvenbag GJ, Iversen P, Newling DW (August 2001). "Antiandrogen monotherapy: a new form of treatment for patients with prostate cancer". Urology 58 (2 Suppl 1): 16–23. doi:10.1016/s0090-4295(01)01237-7. PMID 11502439.
^ ^a ^b Massard, C (June 2011). "Targeting Continued Androgen Receptor Signaling in Prostate Cancer". Clinical Cancer Research 17 (12): 3876–883. doi:10.1158/1078-0432.ccr-10-2815.
^ ^a ^b Akaza H (Jan 2011). "Combined androgen blockade for prostate cancer: review of efficacy, safety, and cost-effectiveness". Cancer Science 102 (1): 51–6. doi:10.1111/j.1349-7006.2010.01774.x. PMID 21091846.
^ ^a ^b Flores E, Bratoeff E, Cabeza M, Ramirez E, Quiroz A, Heuze I. (May 2003). "Steroid 5alpha-reductase inhibitors". Mini-Reviews in Medicinal Chemistry 3 (3): 225–37. doi:10.2174/1389557033488196. PMID 12570838.
^ ^a ^b "Gonadotropin". Retrieved 9 December 2011.
^ ^a ^b ^c ^d Dr. Amanda Oakley. "Hormonal treatment".
^ ^a ^b Zouboulis CC, Rabe T (March 2010). "Hormonal antiandrogens in acne treatment". Journal of the German Society of Dermatology 8 (Suppl 1): S60–74. doi:10.1111/j.1610-0387.2009.07171.x. PMID 20482693.
^ "Steroidal Antiandrogens". Health and Prostate. Retrieved 9 December 2011.
^ Witjes FJ, Debruyne FM, Fernandez del Moral P, Geboers AD (May 1989). "Ketoconazole high dose in management of hormonally pretreated patients with progressive metastatic prostate cancer. Dutch South-Eastern Urological Cooperative Group". Urology 33 (5): 411–5. doi:10.1016/0090-4295(89)90037-X. PMID 2652864.
^ ^a ^b Curtis LR (Mar 2001). "Organophosphate antagonism of the androgen receptor". Toxicological Sciences 60 (1): 1–2. doi:10.1093/toxsci/60.1.1. PMID 11222865.
^ ^a ^b Darbre PD, Harvey PW (Jul 2008). "Paraben esters: review of recent studies of endocrine toxicity, absorption, esterase and human exposure, and discussion of potential human health risks". Journal of Applied Toxicology 28 (5): 561–78. doi:10.1002/jat.1358. PMID 18484575.
^ Yang, Sarah (12 May 2003). "Chemical in Broccoli Blocks Growth of Prostate Cancer Cells, New Study Shows". Retrieved 8 April 2015.
^ "Plant-derived 3,3'-Diindolylmethane is a strong androgen antagonist in human prostate cancer cells". 6 June 2003. Retrieved 8 April 2015.
^ Grant P (2010). "Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome. A randomized controlled trial". Phytotherapy Research 24 (2): 186–188. doi:10.1002/ptr.2900. PMID 19585478.
^ Akdogan M. Tamer MN. Cure E. Cure MC. Koroglu BK. Delibas N (May 2007). "Effect of spearmint (Mentha spicata Labiatae) teas on androgen levels in women with hirsutism". Phytotherapy Research 21 (5): 444–7. doi:10.1002/ptr.2074. PMID 17310494.
^ Bonham M, Posakony J, Coleman I, Montgomery B, Simon J, Nelson PS (2005). "Characterization of chemical constituents in Scutellaria baicalensis with antiandrogenic and growth-inhibitory activities toward prostate carcinoma". Clinical Cancer Research 11 (10): 3905–3914. doi:10.1158/1078-0432.ccr-04-1974.
^ Papaioannou M, Schleich S, Roell D, Schubert U, Tanner T, Claessens F, Matusch R, Baniahmad A (December 2010). "NBBS isolated from Pygeum africanum bark exhibits androgen antagonistic activity, inhibits AR nuclear translocation and prostate cancer cell growth". Invest New Drugs 28 (6): 729–43. doi:10.1007/s10637-009-9304-y. PMID 19771394.
^ Schleich S, Papaioannou M, Baniahmad A, Matusch R (July 2006). "Extracts from Pygeum africanum and other ethnobotanical species with antiandrogenic activity". Planta Med. 72 (9): 807–13. doi:10.1055/s-2006-946638. PMID 16783690.
^ Schleich S, Papaioannou M, Baniahmad A, Matusch R (May 2006). "Activity-guided isolation of an antiandrogenic compound of Pygeum africanum". Planta Med. 72 (6): 547–51. doi:10.1055/s-2006-941472. PMID 16773539.
^ Zamansoltani F, Nassiri-Asl M, Sarookhani MR, Jahani-Hashemi H, Zangivand AA (August 2009). "Antiandrogenic activities of Glycyrrhiza glabra in male rats". Int. J. Androl. 32 (4): 417–22. doi:10.1111/j.1365-2605.2009.00944.x. PMID 19515171.
^ Jiang C, Lee HJ, Li GX, Guo J, Malewicz B, Zhao Y, Lee EO, Lee HJ, Lee JH, Kim MS, Kim SH, Lu J (January 2006). "Potent antiandrogen and androgen receptor activities of an Angelica gigas-containing herbal formulation: identification of decursin as a novel and active compound with implications for prevention and treatment of prostate cancer". Cancer Res. 66 (1): 453–63. doi:10.1158/0008-5472.CAN-05-1865. PMID 16397261.
^ ^a ^b Gao W (2010). "Peptide antagonist of the androgen receptor". Current Pharmaceutical Design 16 (9): 1106–113. doi:10.2174/138161210790963850. PMID 20030610.

UpToDate Contents

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1. 女性におけるアンドロゲン欠乏症および治療の概要 overview of androgen deficiency and therapy in women
2. アンドロゲン除去療法による副作用 side effects of androgen deprivation therapy
3. 去勢抵抗性前立腺癌：アンドロゲンのシグナル経路を標的にする療法 castration resistant prostate cancer treatments targeting the androgen pathway
4. アンドロゲン受容体障害の診断および治療 diagnosis and treatment of disorders of the androgen receptor
5. アスリートにおけるアンドロゲンおよびその他のホルモンの使用 use of androgens and other hormones by athletes

English Journal

In vitro nuclear receptor inhibition and cytotoxicity of hydraulic fracturing chemicals and their binary mixtures.

Bain PA1, Kumar A2.
Chemosphere.Chemosphere.2018 May;198:565-573. doi: 10.1016/j.chemosphere.2017.12.057. Epub 2018 Jan 9.
PMID 29433907

Additive effect of simultaneous continuous administration of degarelix and TAK-448 on LH suppression in a castrated rat model.

Stalewski J1, Hargrove DM2, Wolfe M2, Kohout TA2, Kamal A2.
European journal of pharmacology.Eur J Pharmacol.2018 Apr 5;824:24-29. doi: 10.1016/j.ejphar.2018.01.033. Epub 2018 Feb 3.
PMID 29378196

Comparison of the effect of the antiandrogen apalutamide (ARN-509) versus bicalutamide on the androgen receptor pathway in prostate cancer cell lines.

Koukourakis MI1, Kakouratos C1, Kalamida D1, Mitrakas A1, Pouliliou S1, Xanthopoulou E1, Papadopoulou E1, Fasoulaki V1, Giatromanolaki A2.
Anti-cancer drugs.Anticancer Drugs.2018 Apr;29(4):323-333. doi: 10.1097/CAD.0000000000000592.
PMID 29381490

Japanese Journal

CRPCに対する新規アンドロゲン受容体アンタゴニスト (特集去勢抵抗性前立腺癌 : 基礎と臨床の最新研究動向) -- (最新の治療法)

上村博司
日本臨床 72(12), 2164-2169, 2014-12
NAID 40020270929

去勢抵抗性前立腺癌におけるアンドロゲンレセプターとアンドロゲンシグナル経路―新規治療薬の展望

大日方大亮,高橋悟
日大医学雑誌 73(3), 134-139, 2014
… The androgen receptor (AR) plays a critical role in the progression of prostate cancer. … However, several studies have shown that the majority of CRPC express AR and androgen-responsive genes, indicating that the AR signaling pathway is still functional under androgen-depleted conditions. … Therefore, understanding these mechanisms has promoted the development of new anti-androgens and androgen-depleting agents. …
NAID 130005070914

ホルモン療法の方法論 : CABか?去勢単独か?間歇投与か?持続投与か? (特集前立腺がんの新展開)

島居徹
腫瘍内科 12(5), 530-536, 2013-11
NAID 40019899574

Related Pictures

★リンクテーブル★

リンク元	「抗アンドロゲン薬」「アンドロゲン遮断薬」

「抗アンドロゲン薬」

　　[★]

英: antiandrogen
同: アンドロゲン拮抗薬 androgen antagonist、男性ホルモン拮抗薬 male sex hormone antagonist
関: 抗アンドロゲン、前立腺肥大症

[show details]

抗アンドロゲン剤 : 約 16,100 件
抗アンドロゲン薬 : 約 55,300 件
抗アンドロゲン製剤 : 約 1,100 件
抗男性ホルモン剤 : 約 12,800 件
抗男性ホルモン薬 : 約 33,400 件
抗男性ホルモン製剤 : 36 件
アンドロゲン拮抗薬 : 55 件
男性ホルモン拮抗薬 : 14 件

前立腺肥大症や前立腺癌の内分泌療法に用いられる。

合成エストロゲン

ホスフェストロール

アンドロゲン受容体に対する競合阻害

アリルエストレノール、

(ヒドロキシプロゲステロン誘導体)シプロテロン、
(合成黄体ホルモン製剤)クロルマジノン、
(テストステロン系)オキセンドロン：前立腺でアンドロゲンと競合阻害し、アンドロゲンのアンドロゲン受容体への結合を阻害。

「アンドロゲン遮断薬」

　　[★]

英: androgen antagonist
関: アンドロゲン拮抗薬

[1] "Medical Dictionary: Anti-androgen".

[Mowszowicz-2] Mowszowicz I (1989). "Antiandrogens. Mechanisms and paradoxical effects". Ann Endocrinol (Paris) 50 (3): 50(3):189–99. PMID 2530930.

[Gillatt-3] Gillatt D (2006). "Antiandrogen treatments in locally advanced prostate cancer: are they all the same?". J Cancer Res Clin Oncol 1: S17–26. doi:10.1007/s00432-006-0133-5. PMID 16845534.

[hyperandrogenism-4] "Medical Dictionary: Hyperandrogenism".

[Gray-5] ^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j Gray LE, Ostby J, Furr J, Wolf CJ, Lambright C, Parks L, Veeramachaneni DN, Wilson V, Price M, Hotchkiss A, Orlando E, Guillette L (2001). "Effects of environmental antiandrogens on reproductive development in experimental animals". Human Reproduction Update 2 (3): 248–64. doi:10.1093/humupd/7.3.248. PMID 11392371.

[Rider-6] Rider CV, Furr JR, Wilson VS, Gray LE Jr (Apr 2010). "Cumulative effects of in utero administration of mixtures of reproductive toxicants that disrupt common target tissues via diverse mechanisms of toxicity". International Journal of Andrology 33 (2): 443–62. doi:10.1111/j.1365-2605.2009.01049.x. PMC 2874988. PMID 20487044.

[Antiandrogendrugs-7] "Antiandrogen Drugs".

[Canadian-8] "Anti-androgens for sex offenders". Canadian Medical Association Journal 109 (4): 257. 1973. PMC 1946843. PMID 20312137.

[pmid11502439-9] Kolvenbag GJ, Iversen P, Newling DW (August 2001). "Antiandrogen monotherapy: a new form of treatment for patients with prostate cancer". Urology 58 (2 Suppl 1): 16–23. doi:10.1016/s0090-4295(01)01237-7. PMID 11502439.

[Massard-10] Massard, C (June 2011). "Targeting Continued Androgen Receptor Signaling in Prostate Cancer". Clinical Cancer Research 17 (12): 3876–883. doi:10.1158/1078-0432.ccr-10-2815.

[Akaza-11] Akaza H (Jan 2011). "Combined androgen blockade for prostate cancer: review of efficacy, safety, and cost-effectiveness". Cancer Science 102 (1): 51–6. doi:10.1111/j.1349-7006.2010.01774.x. PMID 21091846.

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androgen antagonist